A case for pencils

Well, now that we’ve accepted that uncertainty is foundational, I feel relieved. It’s kind of a burden to pretend like you could possibly know anything for sure, from what is going to happen, to who you will be tomorrow. This pandemic period has been a time of forced and uncomfortable introspection for me; seeing parts of myself that I could ignore or hide when things were in a more predictable system, like fear and selfishness and loneliness, all the emotions (or are these emotional concepts?) I find myself seeking to control, if not stamp out completely.

In this battle with self to control, I have relied on planners. I would even call myself a planner. I have three virtual calendars, one personal, one for each of two jobs. And then, on top of that, I keep a paper planner. I love my paper planner. It’s a little notebook with calendar pages and blocks for each day where you can write details. I don’t actually write in it nearly as much as I used to, but I use it to visualize the map of my month.

This year’s calendar was full of plans written in pen. Things that were solidified because the tickets were booked, the arrangements were made. I’ve crossed through them all, but I still see them and am reminded of the shadow year running parallel to this actual reality that I find myself in. It’s like my expectations, which had become almost a script, are there, hovering in some liminal space.

This morning, as I was doing some planning, I stopped myself (in the nick of time) as I reached for a pen. Have I learned nothing?! I opened the nightstand drawer and grabbed a pencil, reassuring in its impermanence. Something strangely comforting in embracing, instead of the script, the fact that in truth I had no idea what would happen.

This past week, carrying the weight of a backpack once again, I started thinking about maps. The broad outline that illustrates what trail you are to follow, but tells you little about what you might encounter along the way. For us, that was sunshine and a little fog, a few joyful people passing by, wild ponies, and the layers of Blue Ridge Mountains that provided us refuge. It was a fuel canister that I thought wouldn’t light, a campsite that we hoped would appear before it finally did, an evening windstorm to fall asleep to. It was a reminder that as I spin around in little circles, the mountains go on being mountains.

And I think to myself, isn’t it strange that we draw the map of our lives as we go? We draw it to fit and then act like we were following some predetermined path, imagining that we are in control of our direction. I think this is beautiful, really, that we are able to pivot and then convince ourselves that we knew where we were going all along. I think about this in light of diabetes and where it continues to lead me – on to new stages and challenges. My newest challenge with diabetes is that I forget about it. It’s not that I forget to take care of it, rather, whereas once I resisted it and later I embraced it, now I just sort of do it. It’s always there, keeping me on my toes, but running in the background. Chronic conditions become just another weight in the backpack that we carry (have I mentioned that I love trail and river metaphors). And yesterday, as I wondered why I felt so mentally tired after what was otherwise not a very difficult day, in the middle of a global pandemic in which I am aware to a greater extent than ever of just how privileged and lucky I am, I remembered – oh, I have a chronic condition. And if I’m being honest, I have multiple, because diabetes is never just diabetes. And that was comforting too. To know, to have an explanation. To feel justified in my exhaustion at the end of the day, yet no less certain that I would pick up the pack tomorrow.

When I started writing this I got stuck here. Because I like to have at least a small glimmer of a point, you know, when I write. And I wasn’t sure what it was. Partly, I think I’m just really into planning in pencil right now, as if it were a creative act. I’m into the idea that I won’t be done in this process of knowing myself with diabetes, of knowing myself at all. I’m into the idea that I can set down some of the need to control, because my pack already feels a little heavy some days. And then I started thinking about some of the media that I’ve been consuming during the past few months, particularly after listening to Brené Brown’s recent ‘Unlocking Us,’ podcast, On My Mind: RBG, Surge Capacity and the Play as an Energy Source. For me the most salient point was the first that she made, being that if something was on her mind, she had found that likely it was on our collective mind as well; it’s just we don’t always share the things we feel troubled or embarrassed by. That and the part about Surge Capacity, in which she referenced the work of Tara Haelle, Your ‘Surge Capacity’ is Depleted – It’s Why You Feel Awful. I admit, I haven’t yet read the article yet, but in listening to Brown describe her takeaway, I was reminded of a conversation that I had recently with a friend about this process of creating a ‘new normal,’ around Coronavirus and whether or not that struck me, as someone who has created a ‘new normal’ around a chronic condition, as an apt way to describe what we were doing. I really appreciated the insightful question, because it’s easy to forget even as a person with diabetes all of the work that goes into the creation of normalcy every day, so for someone else to draw the connection was validating. And thinking about it, yes, I do think that Coronavirus has presented us as a society with both the fear of an acute crisis and, basically, management tasks that are very like living with a chronic condition. It’s also introduced the sort of uncertainty that I’ve tried to conquer related to diabetes for years – the kind that makes you feel like if you could just plan everything out enough, you could know what was going to happen with your blood sugar and you would know that you would be safe and able to do what you feel like you should be able to do in this body. Hmm.

So, the world has a chronic condition with clear and not so clear management tasks, and like any chronic condition, people are managing it in a host of different ways. And, like I’m experiencing with diabetes, the process of finding normalcy tricks us into thinking things are normal, and we forget about all of the work that we’re doing to get there. Two other things come to mind here – one being a part of Celeste Ng’s book, Little Fires Everywhere, right after Lexie has an abortion and Mia tells her (something like) that she’ll get through it, but it will be something that she always carries with her, informing who she is/her future. I’m also watching Call the Midwife right now, Season 9. In Episode 2, Sister Julienne says something along the lines of (paraphrasing), “So, I have to accept the world the way it is, rather than the way I wish it to be.” Take from these connections what you will. For me, it reminds me that I have accepted diabetes as one of those things that I can’t put down. A good reminder, because it’s easy to forget what we and others are carrying into any new situation – the layers that begin to stack up when we’re all under collective stress. And in this situation, I think, also hearkening to diabetes management, that it’s just about making the next best decision with the information that I have in this moment. Maybe this tiring time is a good reminder, since there are certain things I can’t let go of, to shed some of the burdens that I’ve wrapped diabetes up in, like a need for absolute control or a need to function at a higher capacity, as if it wasn’t any work at all, or shame about the negative emotions that sometimes come along with it. And to remember that while it may be a little heavy at times, carrying it along with me is necessary to get to wherever (and who knows where that is, really) I’m headed next.

Mining the World

On one of my final days before moving out of the condo I had lived in for the past 3 years, I sat on the back patio and stared at the back of the house. We were on the second floor, so I had to look up to see our kitchen window, illuminated by a soft overhead light and filled to the edges with plants. Their leaves and tendrils twisted around each other and threatened to exceed the small space we had offered them. I was excited to move my plants to my new home and have space for even more. That night the moon was halved. I looked around the space where we had hosted birthday parties and family gatherings, grilled, played music, sat in a kiddie pool and listened to cicadas and swatted off mosquitoes. My gaze came to rest on a cedar tree growing close to the base of the structure and suddenly my eyes began to water, and I found I was crying. My tree. I would be leaving my tree. I had this sense that it had become my job to protect the tree and now I was abandoning it. How strange, that just pure proximity had made this tree mine in my mind. As if I had claimed the land that it grew in simply by resting my head on top of it. Starkly, I realized this was certainly not and had never been my tree. If anything, I thought, this tree is not looking to me for protection, but rather looking at me as one more of a revolving series of squatters, encroaching on its root system, tying boats and bikes to its trunk.

Strangely, after seeing the backyard of my new place only one time, I had already claimed the tree that grew behind it as mine. I knew this to be true because I thought of it as, “my new tree.” This is all weird, I know. Why am I even writing about this? But I think it is worthwhile. How could I go so quickly from invading a new space to claiming it completely as mine? And how could it almost evade me that once I had decided to move on, I barely even thought about the elements I had previously claimed that I was now leaving behind?

I’m always mining the world. It’s not that I think I’m alone in this, but I do it, and unconsciously. It’s fundamental to our whole way of living to mine the world. I love my new place – I’ve strung my stuff all around it so that I see myself staring back at me in tangible form. The plants are my favorite. Yet, I don’t even pause to ask if they serve any other purpose than my happiness. Isn’t this kind of atrocious? How would it be different if I belonged to them?

Of course, I know objectively that they serve so many purposes other than my happiness. But I rarely pause to place myself in their world rather than the other way around. I’ve been thinking about this lately in my interactions with the plants (I don’t think this blog post would have come out of any time other than COVID days). This re-situation is easier with bigger beings, like the tree in the backyard. The tree in the yard behind the house where I now live is a maple. It has almost black ridges on its thick bark from age. It is full of cicadas and they are crying out so loudly right now, singing for summer. The sun hits the branches of the tree and spills shade over the green table. I realize that to not claim the tree requires a lot of prose. This is interesting. What was ‘my new tree,’ takes a new shape, its details emerge. I see it more clearly now. And I see me more clearly, as a changing being, without as much need to claim the boundaries of the space or the details of the moment.

Independence from expectations

It’s time like these I remember again that everything is uncertain, always. I thought I had grasped that concept before, but the pandemic has taken it to a whole new level. See before, I was thinking about it from within the microcosm of my life; like, everything is uncertain: you never know when you’ll be diagnosed with a chronic condition, or lose your job, or win a gift certificate to a barbecue restaurant from a folk festival raffle. You just never know! I didn’t expect to have to think about it on a macro level: everything is uncertain, you never know when the planet itself will be diagnosed with a chronic condition, when millions of people’s jobs will be dissolved, when the foundation of festivals, concerts, weddings, funerals, the celebrations and ceremonies we build our lives around, will fall away, leaving us…stripped down, unadorned by the trappings of tradition.

I’m thinking about this on the Fourth of July, aka Independence Day. When this all began, I remember being intensely sad about the world. Then I remember allowing myself to also feel sad about all of the things I was looking forward to in this year that would clearly not be happening. But now, longing for trips, conferences, concerts, feels sort of like longing for a sunroof when you don’t have a car. What an amazing exercise in becoming aware of everything we were taking for granted! Layers upon layers of granted. Not just the feelings, the forces, that we take for granted, like love, but all of the ways that we acknowledge it in our daily lives. As another friend is likely postponing her wedding ceremony, I think about how invisible so many of the things that make life rich are until they are unavailable. When I first moved to town and didn’t know anyone, I was lonely. I had a strong community in Asheville and it’s a hugging place, so I would hug or pat on the back or sit next to a friend nearly everyday. In my new town, before friendships had really been made, I was operating at a closeness deficit. I remember riding the crowded bus home from school and feeling so comforted just by being near to other people. In our present reality we are separated by a force field of threat from friends and strangers, and this calls into question what being close to other people really does for us. How being separate makes us, in a way, trapped with ourselves. And for many, I’m sure it makes us long to reach out and connect in a small, simple way, like a hug or a conversation close enough to see the other person’s pupils, that we didn’t even know was so meaningful.

Each year on July 4th I like to declare myself independent from something that’s holding me back. This year, I’m declaring myself independent from my expectations for how things were supposed to go and how they are supposed to be in general. But bigger than that, I’m declaring independence from my expectations about the ingredients of happiness within a given experience. I’m letting the word happiness stand in for whatever pure, unadulterated feeling is necessary for meaningfulness. To be clear, adequate resources, shelter, relative security, all of these are necessary for what we think of as long-term happiness. But in the moment, the kind of food on a shared table, the airplane ticket to a far-off place, the goal and the striving for the next work or life accomplishment, all seem starkly independent from the point. And, knowing that what I really miss now is the ease of connection, once all those other things are accessible again, I hope to remember that.

Snakes (and diabetes)

Just kidding. This is just about snakes.

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One snake, really.

Sometimes I hear people say things like, “I hate snakes.”

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Ok. Maybe they have their reasons.

But, in case they don’t…

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I would advocate for a reappraisal.

I’m not saying they’re good to cuddle, or would make a great pet (why reduce wildness, anyway?).

Of all the vicious forces in the world, she seems an unlikely enemy.

leaves

Lately I’ve been on a ‘getting rid of stuff’ kick. I’ve given away several bags of clothes, donated books to the library, shredded mounds of semi-private information and bank statements, cut up clothes I should have already been using for rags, and just thrown some stuff away. One thing I recently gave away was a book called, Zen and the Art of Diabetes Management. Turns out, maybe I should have read it.

I don’t know if my shedding belongings is connected to my deeper desire to shed emotional and mental refuse, i.e. the crunchy, brown leaves of thought and preoccupation that long to fly free from the branches of my mind, but it’s possible. A note on this – I was recently out for a walk, when I came around the corner and stumbled upon a pile of leaves so high and long that I was immediately enraged at: leaf blower machines (they require so much gasoline), the thought that a homeowner would be so careless as to jeopardize the safety of all who walked and drove on the road (half of the street, on a curve, was piled six-feet high with leaves), and the fact that we thwart the natural process of composting and earth replenishment by bagging and throwing away leaves. I find it bizarre. Then I walked past the great wall of leaves, turned, and looked up at the nearly denuded oak tree whose branches twisted and furled in every direction. The pile was mostly oak. This one tree had blanketed the yard, filled the road, and was left standing above what it had discarded from the previous year. I smiled at its abilities. The wind blew and I walked on.

What a diversion, you say, from the original point of this post. But I’m getting back to it.

So, I’ve been going, very irregularly, to a Zen center for meditation with others. I find these accountability buddies help me very much. I don’t have to hold all that silence alone. And this past week there was a lecture, which I didn’t know about, but felt compelled to stay for (because I had meditated for 30 minutes and was actually calm enough to consider staying for an unexpected lecture). The teacher, a woman who exudes peace and goodwill, talked about an experience she had near the Zen-dō, seeing a plastic bag on the ground and experiencing anger, only to ask herself, “is it trash, or is it my mind?”

Her question brought me back to the tree and its pile of leaves. Here I was, painfully debating over whether to keep each t-shirt, each novel that I’d read or never wanted to read, and more than all that, deciding what I wanted to mentally let go of, and here was this tree, who had just let it all go. And I just expected it to, not even marveling at its abilities to grow and grow and grow, and then courageously release the product of its work. All this stuff, these thoughts, the richness of past experiences, they become our soil. We have them, we grow, and then the we move on. Needing and desiring to let them go does not mean that they weren’t good or that they are wasted – it’s just natural. It’s time, I thought, to take the mind out of it, stop deciding, and just to feel what is dry, crunchy, no longer producing fresh growth and let it fall to the ground, where it can be good again.

Back to Zen and the Art of Diabetes Management. I had read some of it – a good book – about managing diabetes with an attitude of peace. But currently, I’m trying to figure out how to manage feeling at peace while maintaining diabetes in mind. Remember the name of the blog, Adventurous Living with Diabetes in Mind? That is totally possible, but it sort of defeats the purpose of meditation if diabetes is in mind…doesn’t it? I thought that the point of meditation was to clear the mind of all thoughts…so nothing should be in there. Especially nothing as seemingly mundane as, ‘what’s my blood sugar?’

Sometimes it feels like my whole life is a pancreas meditation – instead of trying to get down to the truth of who I am in a sitting session, I’m trying to get down to the truth of my pancreas, ‘what are you doing buddy?!?’ And – ‘how am I doing?’ I had felt low about 30 minutes before I had to leave the house to drive to the Zen-dō, so I ate a few extra slices of apple. I checked about 10 minutes before I had to leave and I was 99 mg/dl, meaning I was fine to drive (I don’t drive when low, i.e. <80 mg/dl). Because the meditation was longer than usual, and I unaware of this fact until in the middle of it, my thoughts started to creep to what my blood sugar might have crept up to. Usually I take a walk in the morning after breakfast – I factor this movement into my insulin dose knowing it will bring my blood sugar down immediately. I hadn’t walked, but of course I’d limited my carbs at breakfast, but it had been a long time since I’d last taken insulin and I knew those last couple slices of apple wouldn’t have been reflected in my pre-driving number because it takes about 20 minutes for any change from what I’ve eaten to show up on my meter so…

Is it blood sugar, or is it my mind?!

We’re all up against a lot of obsessive thought. And here’s the thing, mine and everyone else’s matters and, often, makes sense. So I sat there during the Zen lecture listening but also wondering what my blood sugar was and how I would ever stop wondering about it long enough to be fully present. So I decided to feel. I started with my breath, how did it feel in my body, and then my heart, moving outwards towards my toes and fingertips. I felt good. I stopped feeling like a mind-pancreas in a body and began to feel like a whole being. I thought of blood sugar again. I went back to thinking about breath.

I got back to my car with my meter (where my mind had been part of the time) and checked my blood sugar, it was 139 mg/dl – hardly a number to worry about. I thought back to the teacher’s story, about becoming angry when she saw a plastic bag that someone had carelessly tossed on the ground, and then realizing she could simply pick it up, and put it in the trash (*yes trash, not recycling, because plastic bags clog the recycling machines so should only be recycled at grocery stores, where they have those designated plastic bag receptacles). When she realized she could take action, throwing the bag away, she felt a sense of peace and moved on about her work, she told us. I think I had this option too with my blood sugar. Diabetes takes a lot of action (and that action is required for health and in fact, survival). Something I’d like to work on in meditation is relegating the heavy thought to moments when action is needed. I knew I was safe in the Zen-dō, diabetically speaking. I could feel that I wasn’t too low or dangerously high, and I made the choice to stay. I could have left and dealt with my blood sugar, satisfied that piece of me that has to know, but I didn’t. And the koan for me, and everyone in the room, was to be fully there, blood sugar and all.

I don’t know. The end to this blog post is – I really don’t know. I’m in no way trying to minimize the necessity of thinking about blood sugar for a person with diabetes, but I’m thinking about ways to move towards fuller presence – unified body and mind – without layers of judgement, in regards to diabetes management. I’m taking recommendations, asking for them really. Maybe I should have kept the book, or maybe I just need to revisit the tree.

Walking through Innsbruck

To awaken quite alone in a strange town is one of the pleasantest sensations in the world. – Freya Stark

I stayed in a small Air BnB across an azure blue river that ran straight through the middle of Innsbruck. I walked there for the first time from the train station – my gracious host offered to pick me up, but I screwed up military time in a text message and told him I was coming 2 hours after my actual arrival. He gave me directions and I looked them up using the train station’s wifi (which was the only way I could use my phone) and headed on my way.

Google Maps estimated a 25 minute walk. I arrived an hour and a half later. Although I was toting my backpack stuffed to the brim, a rolling suitcase, and finally my purse, flung around my shoulders, I wasn’t slowed down too much by my baggage. I just simply couldn’t stop spinning around in circles to take in the shining spirit of the city. Here’s my walk in pictures:

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I strolled across the street to a pedestrian only plaza where shoppers and diners milled and mingled.

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…before finding this strange alley of murals. That closest one is a kiwi on a chicken bone. Perhaps a show of peace among vegans and carnivores (although I’m doubtful).

img_0402.jpg I didn’t stay at this hotel; I just took this picture to prove I was really in Innsbruck.

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I walked across the bridge towards my new abode in the wake of mountains all around.

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Et voila, practically home. The huge wooden door was tucked behind a swath of climbing red ivy between two classically Austrian buildings.

Everyone was walking or biking up and down the steep hills. In many places there were wide pedestrian sidewalks next to double-lane bike paths, bordered by a line of trees and flowers, before finally meeting the edge of a quietly buzzing road on which the motorists dutifully slowed on yellow and stopped on red.

It took me awhile (I mean like two weeks after I returned) to realize why I felt (at least in part) such a sense of peace in Innsbruck. It could have been the mountains all around or the fact that I was at a conference where everyone was thinking and talking obsessively about diabetes (just like me!), but another huge part of it was the pervasive walkability of the city. Pervasive because it was unavoidable – you couldn’t get where you needed to go without walking. It didn’t just feel safe to walk alongside the cars, but in many places there were no cars at all. The restaurant I ate at twice – Osterreich – which I actually thought had something to do with an Ostrich, before I realized how painfully complacent my brain was acting – was only accessible via foot. And, what’s more, the whole time you sat, enjoying grilled chicken or roasted sausages, fluffy piles of freshly grated horseradish, or mounds of sauerkraut, you could watch, not cars whizzing by, but a live feed of humans doing human things.

IMG_0475.jpgFor example, this brass band bedecked in green, who lined up to play in the heart of the city.

Walking is one of my favorite things. But also, walking is one of my favorite things about traveling. I’m grateful to have a car, but I don’t like cars. I like moving more slowly through life and having the chance, if I so choose, to reach out and touch it. And diabetes loves a walk. People talk about the benefits of exercise for diabetes management, as if exercise was some strange set of unnatural activities that the body must be guided through. I’ll admit, I go for a run every now and then, and it does bring my blood sugar down, but for me, there’s nothing like walking to bring my body into balance. Adam Brown, a writer often featured on diaTribe, explains the blood sugar benefits of walking beautifully here. When my bg is high, instead of dropping rapidly like I do while running, I glide towards a more reasonably blood sugar. Instead of tiring me out, a long walk makes me ready for another walk, or a night of dancing (lucky for me too, because of all the specialists, pediatric endocrinologists are the best dancers).

My last day in Innsbruck, after cramming my head full of presentations and standing up to do a couple myself, I took myself on a mind-clearing walk. My host had told me there was a tram to the top of the mountain, so I headed up the hill towards the peak. Shockingly, I did eventually find the tram, but then decided that my budget preferred continuing to walk. Oh also, that’s another thing, walking is cheap!

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Not to mention beautiful.

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Gazing out over Innsbruck, I felt overwhelmingly grateful for my experience and for all the people who helped me get there. Although I enjoy the feeling of solo exploration, traveling, more than anything else I think, makes our interconnectedness blazingly obvious. I was guided by countless mentors and passed from hand to hand of old and new friends on this journey. Thanks to each and every one.

Leaving Vienna in the morning

**Monday of this week was World Diabetes Day 2017, so in honor of all my diabetes sisters, brothers, and supporters, this post will offer a little more intimate look at the diadetails of my life than others.

After yoga Monday evening in Vienna, I followed a group of yogi/inis to a delicious dinner of Vietnamese food. Yes, definitely Vietnamese and not Viennese – although I would end up eating a lot of traditionally Austrian fare. I was just a little bit low by the time we arrived at the restaurant [70 mg/dl or so], which was really a pleasant surprise after battling some higher numbers on the sedentary plane ride. I ordered an ‘Elderberry Water,’ description in German, so I was taking a total leap. It was, in fact, an elderberry-infused glass of water – and totally delicious.

I also ordered several other things – Vietnamese crepes and spring rolls with interesting mayo-based sauces. As a lover of sauce I was delighted. I was also almost delirious from exhaustion, approaching the evening of the day that should have been a night, but it was wonderful to be sitting at a table with people living their lives in this new city I’d just stumbled in to.

That night, teeth brushed, ready to climb the ladder to my lofted bed, I found the walk back to the apartment could not compete with the long plane flight, screwed up schedule, and reduced control over food choices. Nevertheless, despite a blood sugar of 201 mg/dl, I took an extra shot and crawled happily into bed.

Every morning I wake up and check my blood sugar. Then, as my coffee is percolating, I take my shot – the same amount each morning unless something exceptional is happening that day. I have my first cup of coffee and plan the day while my insulin activates, so to speak. It’s a wonderful routine – a forced stillness and reflection courtesy of diabetes. When I awoke in Vienna to a dreamy light pouring into the vaulted living room, my blood sugar had evened out to some degree (mid-hundreds). I drank my coffee staring out onto the criss-cross of streets below and apartment windows across.

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Unless you have it, at this point you may need a diabetes glossary to understand a few concepts:

Walk competing with a plane ride…What?

Insulin activating…Hmm?

The day-to-day details of life with diabetes are heightened when traveling, precisely because of the exciting release of control that a good adventure requires. So at the same time that you’re sinking into the moment, diabetes can loom even bigger in the back of your mind. But I’ve learned, slowly, painfully over the years, to not let it steal the joy of the unknown from me.

A few ways I’ve successfully experienced this reclaiming of joy:

  • Allow myself a wider target range while traveling – if I’m not dropping dangerously low at night, I’ve succeeded! Likewise, as long as I can bring a high blood sugar down, things are fine. Interestingly, often this more ‘relaxed’ attitude brings with it surprisingly ‘good’ numbers.
  • Tin foil and plastic Ziplock bags at all time. How could a Ziplock bag improve my bg numbers while traveling? – you ask. Well, this may not be true for everyone, but I am the sort of person who doesn’t need to eat a whole treat to be satisfied, but who feels utterly denied if I can’t try a bite of something I’m offered. I don’t typically buy or order things that don’t support my blood sugar, but if they are there and free – I just gotta know. There are only a few exceptions I turn my nose up at completely (likelihood increases if said ‘food’ is enveloped in sealed plastic). So if I get a treat while traveling, say a flakey pastry pinwheel like they displayed on small square, porcelain plates at the conference during coffee breaks, I have a delicious bite (sometimes two) and pop it in the bag. Although often I throw away the remains before completely consuming it, it’s still less waste overall because one treat extends over a whole day, or sometimes even two or three (remember to refrigerate when necessary)!
  • And let’s talk about refrigeration. I always arm myself with a doctor’s note before traveling that states that I will be traveling with my medications and that they will need to stay cool. Perhaps because of this, or maybe my medical id bracelet (also essential when traveling alone), or because I am open about proclaiming my diabetes in airports, I have always been able to carry a little cooler with me without being stopped for having what is technically an ‘extra’ carry-on bag. I never let this cooler out of my reach – not to put it in overhead bins and definitely not to check it. I’m curious if others with T1D have successfully traveled with small coolers. Mine is soft and I use a little tiny icepack – which does flag the security scanners sometimes. Both times this has happened I have been cleared to continue on my merry way.

My diabetes travel guidelines in summary:

  • Be kind to myself, aka loosen up
  • Carry Ziplock bags or tinfoil
  • Be open/up front about diabetes

I packed a yogurt in my icepack for my four-hour train journey to Innsbruck, during which I would retrace on the ground the route I had flown the previous day. I jostled back in forth from one side of the train to the other trying to catch views of mountain peaks and aquamarine waterways, before finally being lulled into a nap by the hum of the rails.

 

Travels with Diabetes, Part 1: Boston to Vienna

I returned about a week ago from a ten night trip spanning Boston, Vienna, and Innsbruck. See timeline below:

Night 1: Boston > Night 2: The sky > Night 3: Vienna > Night 4 – 8: Innsbruck > Night 9: Vienna > Night 10:Boston

Along the way I was blessed to have the company of my gracious hosts in various cities, my mentors at the ISPAD (International Society for Pediatric and Adolescent Diabetes) Conference, and others who are passionate about diabetes care and research just like myself. In fact, the abundance of miracles that transpired during my time has left me in awe. Still, traveling with diabetes, my constant companion, was as always, a little tricky. Diabetes can really be a pain – especially when your body is tired and out of its normal routine. So this post is going to employ grounded idealism – which I find is becoming my default (side effect of aging?) – and will follow a ‘challenge,’ ‘reward,’ ‘strategies’ format.

Challenge: Many legs of travel make for a lot of time on airplanes and lugging around luggage while sort of lost, eating snacky food all day.

Reward: Time with one of my best friends who has recently moved to Cambridge, MA. We explored the city, identified magnificent trees, ate vegan-ish food, and ‘played’ with her turtle Zeke.

Strategies to keep Type 1 diabetes (T1D) happy: I spent about 24 hours in Boston and had plenty of time Monday morning to take a long walk (thankfully the weather was magnificent) across the bridge (in view of the iconic Citgo sign), climbed on some trees, and moved for a solid hour. This brought my blood sugar down, increased my insulin sensitivity, and prepared my body for the long 7+ hour plane ride ahead. If you can’t take a long walk before your flight, some yoga or stretching is definitely better than nothing!

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Flight attendant“What would you like for breakfast?”  Me“Sleep.”

Challenge: Jet lag! And missed sleep while crossing time zones and traveling

Reward: A full day in Vienna

Strategies: So I guess this is always the case, but at the time the wonderful flight crew (thanks Swiss Air, I mean really, you should fly Swiss Air) brought around breakfast, it was 11:30 pm in my world and body. Still, I pressed on, drank another cup of coffee, ate half a croissant, and tried to prepare myself mentally to begin a new day. I learned that perhaps I approached jet lag all wrong. Having slept 0 minutes, I arrived in Vienna and somehow, although I don’t remember the process, made it to my hosts’ 4th story flat. I was graciously welcomed and then immediately fell asleep on the lofted guest bed for 3 hours. One of my hosts woke me and warned that if I slept any longer I’d feel even worse tomorrow. I remembered to check my blood sugar and was pleased to find it wasn’t so bad, 145 mg/dl or so. I took half my Lantus dose, because my schedule was all screwed up and I needed to begin working my doses back towards ‘morning’ and ‘night.’ And then I began the remediation process. After showering and drinking more coffee, I followed my hosts’ directions to Stephansplatz – the city center and location of the giant Stephansdom Cathedral, which I just learned from Wikipedia is one of the tallest in the world. I wandered among the young men in period costumes who showered me with flyers for the Mozart theater experience that I just had to see. I walked inside the giant wooden doors of Stephansdom, carved elegantly and polished, to enter the quiet cavern of worship. It was dark, as most giant cathedrals tend to be, but the stained glass scenes were vibrant and prayer candles lined the front iron rails. I added a candle to the bunch, walked slowly around the wooden floors listening to the echo of my footsteps, snapped a no-flash picture, and exited, emerging again into the light.

My next stop, after more meandering, was my host J’s yoga class at Feel Good Studio. This is what really saved me. Huge life tip: when traveling, look up local yoga studios and see if you can stretch out your body and shake off your jet lag. The amazing side benefit is that many studios offer new student deals, which means that often you might even be treated to a free class. J’s teaching style was just perfect for my state of being – a solid flow with individual attention and mindfulness every step of the way. He recommended plow, with heart lifted toward chin, as one of the ultimate anti-jet lag poses. Afterwards, although I fell asleep completely in savasana, I felt somewhat reenergized and ready to meet the next leg of the trip.

I’m going to break this post up, because it’s important to rest and not rush an adventure in its unfolding.

 

The Best Thing About Backpacking: Part 2

A light breeze was rustling the rainfly when we awoke the next morning, but the downpour was over and waves of sunlight rolled past, lighting up our little orange home. I flipped from side to side a couple of times on the hard ground, trying to keep myself from tumbling down the slope. More sleep being evasive, I was eager to start the water heating for the first cup of coffee in the woods – a unique pleasure that combines two of my favorite things into one. I sat up and put on my old pair of backpacking glasses, found my meter case safely stashed in a plastic bag, and checked my blood sugar. 160 mg/dl – a little high. This was, I thought, to be expected, since I was 137 when I went to bed and I’d cut my Lantus dose by half in preparation for the day of hiking. Better than fighting lows all day, I thought. I unzipped the soaked rainfly which now clung to the tent after its stick stake had crumbled and given way overnight. I managed to haul myself and my pack out from under it and stumble into the bramble patch that we’d appropriated in the night. Ahead of me, a few short oak trees canopied blueberry bushes and huge ferns. Further, at the border where the land turned steeper, big Balsam fir trees spread their evergreen branches into regal teepees. To the right, mountain after soft mountain, rolling in the Virginia way. Behind me, a taller peak with a bright green bald was dotted with what could have been nothing else but a herd of wild ponies.

Unbeknownst to us, we had set up our camp in paradise. I ran back to the tent and crawled into the deflated vestibule. “It’s so beautiful out here!” I shouted to my slowly stirring companions. “Really?” “Oh yeah?” I had already run back outside. The Navigator unzipped the trail side door of the tent, just in time to say hello to a pair of early morning hikers. Also unbeknownst, we had set up our camp at most 10 feet from the Appalachian Trail. In the night, in the rain, it had felt like we were far from the pedestrian thoroughfare. This was an accident of minor importance though. We set up our first breakfast on a small rock to enjoy the views of ponies and passersby. I took about half my normal dose of Novolog to go with a higher carb breakfast than usual and halved my morning Lantus dose (I’m on a split Lantus regimen right now) once again, to set myself up for a day with less lows.

From there the skies just got bluer, in every way. After we’d retrieved our wet clothes from the branches we’d decorated with them, we set off again, this time North on the AT, to begin our ‘loop.’ Within moments we stumbled upon this scene:

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Unlike my last eager venture to Grayson Highlands, I decided that this time I would allow the ponies to come to me if they wanted, but I would not approach them first. Luckily this worked out just fine. They were very friendly. They also seemed intrigued by my hiking poles (just another reason among the many to carry hiking poles).

Sometime later, we said goodbye to the ponies and continued on our way. Light clouds dappled the sky and the colors around us shone in response – bright greens, sunset oranges from the just-past blossoms of the wild, fire azalea bushes. It was slow going because we had to keep stopping to greet and photograph every pony in the area. We could probably provide a pony census to Virginia if it was ever needed. And just when we thought ponies had come to rule the Highlands’ ecosystem, we happened upon…

 

these lovely (and somewhat intimidating) ladies. They were lunching on a high mountain pasture, so we decided to as well. For the first few minutes of lunch I fed the low blood sugar that had crept over me as I gazed out over the 360 degree views in a partial daze. It seems like for those first few hours of backpacking I can’t ever eat enough to keep my blood sugar up. I slowly came back to our beautiful reality while Raindancer, who had quickly become comfortable with the herd, fell asleep for a 15-minute nap.

Somewhere before or after lunch the trail took us over a little stream and we stopped to refill our Nalgenes. Hiking/life in general with diabetes requires a lot of water. I recently learned (remember this for your next trivia night) that diabetes comes from the Latin for: “It has to flow” (I know that clinically this is not a good thing, but philosophically I really dig that slogan). So anyway we got out our Aquamira and engaged in the process of readying our water. In life, I’m not always patient with the process, but there’s something about the process of purifying water with Aquamira that I love. Maybe this is part of ‘the best thing’ about backpacking – engaging deeply with the process of getting where you want to go.

Sometime around 7 pm we made it to a crossroads, literally and figuratively. We needed more water, we had reached a large boulder that supposedly offered good views, and we were tired. We decided to set up camp and go in search of water, rumored to be just around the bend, after eating dinner. Prior to eating dinner though, we ascended the curved face of the boulder and were met with a literally breathtaking view. You hear people say things like, “she looked breathtaking,” or “wow, this sunset is breathtaking,” but if something is really breathtaking you can’t speak because you are gasping. And that’s how this view was – like, “Ahh!” So beautiful, so unexpected. The sea of clouds had parted and the mountains were everywhere. Although I’ve grown to love the Piedmont of NC, views like this remind me that there’s just nothing like having your breath seized by the mountains. Could this be the best thing about backpacking?

Minutes later, I had wondered if perhaps tearing into a tortilla bowl of beans, tofu, cheese, and avocado as you stretch your tired legs out on the bare ground was perhaps the best thing. There’s nothing like eating dinner in the woods when you’re really tired after a day of hiking. Also, here’s where I’ll make my plug for never going backpacking without hot sauce – it’s worth the weight. I carry mine in a small Tupperware given to me by none other than the Navigator, who understands my love of sauces. It’s very lightweight and a huge improvement over the whole glass bottle of Cholula I carried last time I was in Grayson Highlands.

The day was perfect – magical in every way, and so it shouldn’t have been a surprise to us that the night sky would have been perfectly clear, illuminated only by the pinpricks of a million tiny blazes of light. Why should we have been shocked that the ground flickered with the slow awakening of mountain fireflies, who move with more direction and purpose than the rapidly flitting lowlanders? And yet still, with stars above and around us, we stood mesmerized. I’m all about favorites, ultimates, zeniths, etc., and so I could say that if there was a thing that was best about backpacking, it had to be this mountain field under the cover of darkness – air the definition of fresh, a comforting silence filling the space in between the calls of katydids and click-click of bat wings.

But, I just can’t say that. In fact, no one of the miracles of the day could take the title of ‘best thing.’ To categorize our time would have been to leave out the process, the parts of sum; to forget that each moment was a combination of feeling connected to the Earth and to each other. Perhaps, if I want to answer my friend’s question, I’ll land on connection as the best thing about backpacking. It’s different every time, but it happens, somewhere in between bailing water out of the tent with your bandana, spotting a speckled salamander under an old log, and helping each other find the trail.

A quick acknowledgement and plug for the amazing blog of Hiking Bill. He provides in-depth descriptions of many hikes in the Southern Appalachians and includes helpful ‘hike planners’ at the end. 

You can find his description of the Pine Mtn/AT Loop that we used to plan our route here.